As this year’s flu season approaches, health officials are concerned given the status of the coronavirus disease (COVID-19) pandemic. Officials fear that the situation could possibly turn into a “twindemic” and are stressing the importance of getting vaccinated for the flu.
“At this moment in time, we are all accustomed to discussing herd immunity and other epidemiologic parameters,” said David Cennimo, an infectious disease expert at Rutgers New Jersey Medical School. “The influenza vaccination follows these same ideas.”
Cennimo said that the vaccine is important for multiple reasons. First, it helps to protect yourself against the influenza virus, and second, those who are vaccinated are less likely to pass the flu to others.
“We know that immunization decreases the risk of contracting flu and can also lead to less severe symptoms if you do catch the virus,” Cennimo said. “This will work in tandem with the COVID-19 prevention measures to, hopefully, decrease the burden (of) influenza infections.”
As for the specific threat of a “twindemic,” Cennimo said that it is possible to get both viruses at the same time, as was seen last winter when COVID-19 emerged but said the risk is not yet known.
“Influenza cases were already on the decline when COVID-19 hit the U.S.,” he said. “We do not know if infection with both viruses will be common nor do we know the clinical ramifications.”
Cennimo said health experts do know patients are at a higher risk if they have the flu and other viruses simultaneously, so he is concerned that patients could become severely ill if a co-infection with COVID-19 were to occur.
Since the flu and COVID-19 are both respiratory viruses, there are a lot of similarities, he said.
“Both are spread most efficiently through close contact (i.e. droplets and physical contact). The clinical syndromes are both overlapping and described as ‘flu-like illness,’” Cennimo said. “COVID-19 has a much greater percentage of asymptomatic cases who are contributing to transmission making it potentially more difficult to contact trace and contain.”
Cennimo said people claiming that COVID-19 is “no more dangerous than the flu” are likely misapplying the data.
“If I am frustrated, I would tell them that I have been through a lot of influenza seasons including the H1N1 pandemic of 2009,” he said. “This is the first time we have used refrigerated trucks because the morgues were full. The magnitude of the mortality was staggering.”
Cennimo said that the healthcare system itself is in danger, in addition to individual patients, if a “twindemic” were to occur. He said it is important not to overwhelm healthcare providers with the flu, so they can focus on COVID-19.
“Beyond the danger to the individual patient, we have the risk of overwhelming our healthcare system if we are trying to care for many flu patients when another wave of COVID-19 hits,” he said.
At this point, the dangers associated with the second wave of COVID-19 still remain unclear, Cennimo said. He said many people are worried given that the second wave of the 1918 influenza pandemic was worse.
“A bad influenza season (many infections) has the risk of further stretching scant medical resources,” Cennimo said. “We think about overflowing (intensive care units) and rationing ventilators because that is the memory (from) a few months ago. This is again possible and would be horrific.”
Cennimo said access to everyday care and testing is also important during this time.
“Since infleunza and COVID-19 will be clinically indistinguishable, people who are symptomatically ill will need testing,” he said. “We will need to determine which virus you have so that we can properly contact trace and utilize our COVID(-19) protocols.”
He also talked about other precautions people should be taking, in addition to getting the flu vaccine, that will help keep them safe from contracting one or both of the viruses.
“The behavioral factors such as mask wearing, hand washing (and) physical distancing should help prevent both viruses as well as other common winter viruses causing (an upper respiratory infection),” Cennimo said. “The only one we can actively protect ourselves against directly is (influenza) so everyone should get the vaccine.”